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Study Abroad
Faculty/Academic Advisor Recommendation Form
To the student: Please complete two forms and give to one faculty and to one academic advisor, or to two faculty or to
two academic advisors at your home university. We will not accept recommendation forms given to us directly from a
student.
To the recommender: The student named below has given us your name as a person able to provide an evaluation of his
or her qualifications for an academic study abroad program offered through the International Programs & Services office
at Michigan Technological University. Students are selected for this program on the basis of academic ability, as well as
maturity. It is important to the student and to the University that we select only those students who are most likely to
succeed in and benefit from this program. We appreciate your candid opinion as to the applicant’s qualifications. As you
will note below, the applicant has waived right of access to the reference.
The student’s application cannot be processed until references are returned. We would therefore appreciate
receiving your response as soon as possible. Please do not give this form to the applicant, but return it directly in the
attached envelope.
To be completed by the student:
Name of applicant
Telephone
E-mail
Michigan Tech ID Number
Name of home institution or university:
Name of international university for which you are applying:
Semester(s) you plan to study abroad: (Enter term(s) in year format, for exampe, 2010)
Fall Only
Summer Session A & B
Spring Only
Summer Session A Only
Summer Session B Only
Name and title of reference
All rights of access conferred by the Family Educational Rights and Privacy Act of 1974 (P.X. 93-380) as amended, or
otherwise, to all information and materials of any kind received by Michigan Technological University from any source in
connection with this application are hereby voluntarily waived.
Signature of student __________________________________________________________ Date __________________
To be completed by the recommender:
1. How long and in what capacity have you known the applicant?
2. If selected, this student will be required to make an adjustment to a challenging living situation. The student’s success
in the program will be strongly affected by this adjustment of living in a foreign environment. Based on your
knowledge of the applicant, will you give us your opinion of the student’s ability to make such adjustments?
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NOTE: If a foreign language is required for program participation and you have knowledge of the student’s
capabilities, please answer questions #3 and #4. If not, please move to question #5.
3. Please indicate your opinion of the applicant’s present language ability in each of the following categories.
Language:
Listening
Ability
Speaking
Ability
Reading
Ability
Writing
Ability
None
Limited, Basic Ability
Intermediate, Some Inconsistency
Advanced, Can Use Complex Structures
4. What is your opinion of the applicant’s ability to use this language in the host country?
Should have no difficulty
Should be able to manage adequately after a short period of adjustment abroad
Would require considerable training before necessary competence is obtained
5. How would you describe the candidate in terms of maturity, sense of responsibility, reliability, honesty, and
character?
6. Please use this space to make any additional comments you want to make concerning the applicant's qualification for
the program. (Attach an additional sheet if necessary.)
7. Please check the statement that you feel most accurately reflects your opinion of this student’s suitability for the
program.
The student has my strong recommendation
I cannot recommend this student for the program
I have minor reservations, but am willing to recommend the student with the following reservations:
______________________________________________________________________________________________
Signature
Title
Date
______________________________________________________________________________________________
Institution/Firm
Telephone
E-mail
Thank You. Please return this form in a sealed envelope to:
International Programs & Services
Michigan Technological University
1400 Townsend Dr.
Houghton MI 49931
Phone: (906) 487-2160
Updated February 2009
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